Author’s response to reviews
Title: Using medical specialty and selection criteria clusters to study specialty selection by
Israeli medical students
Authors:
Yoram Weiss ([email protected])
Rachel Yaffa Zisk-Rony ([email protected])
Howard Tandeter ([email protected])
Uriel Elchalal ([email protected])
Alex Avidan ([email protected])
Josh Schroeder ([email protected])
Charles Weissman ([email protected])
Version: 2 Date: 09 Dec 2016
Author’s response to reviews:
Reply to the Editor’s Comments
Abstract:
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Change "out-patient" to "outpatient" - done
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The last sentence is missing a period at the end - done
Introduction:
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page 4, paragraph 1, line 89. Remove the comma after "Although" - done
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page 4, paragraph 2. Consider rephrasing "Career clusters, generally, involve..." to "Career
clusters are groups of occupations..." - done
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page 5, paragraph 1. Change "narrowing" to "narrow" - done
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Page 5, paragraph 2. When referencing your work and other work, you switch between
present and past tense; it's a bit confusion. Consider either phrasing all statements in the past
tense, describing your work AND previous work. Alternatively, you could describe your
work in the present tense and past work in the past tense. But I think putting all in the past
tense is better, because your Methods section is written in the past tense. – All phrasing has
been changed to the past tense.
Methods:
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Page 8, paragraph 3. Omit "plus the middle point" - done
Results:
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Page 12, paragraph 1. You use the phrase i.e. twice in one sentence (line 279-281). It is
confusing. Please rephrase. You have a tendency to use i.e. as a filler in your writing, and I
would suggest you break this habit by forcing yourself to write out what you mean in full
words (in this manuscript and henceforth). – the sentence has been revised” “However, this
analysis revealed a "reciprocal" aspect to the cluster pattern. This indicated that these
students were surgically averse and had little interest in general surgery, surgical
subspecialties, orthopedic surgery, ENT, plastic surgery and ophthalmology.”
Discussion:
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Page 13, last words of first paragraph. Residency programs in the United States are affiliated
with hospitals and hospital systems, not medical schools. Please change "United States
medical schools" to "United States hospitals." - Changed
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Page 14, paragraph 1. Please add a comma after "Moreover." The phrase "(of the 110
students interested in pediatrics..." should be a separate sentence. - Revised: “Moreover,
there was a moderate overlap among those interested in these two specialties. Of the 110
students interested in pediatrics and 68 in family medicine, 36 were interested in both
specialties.”
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Page 15, first paragraph. The difficulty recruiting students to family medicine is a nearly
universal problem that has been described in medical education systems throughout the
world. Instead of stating, "in some countries has difficulties recruiting sufficient residents" I
would use "many" or "most". "Some" is a bit of an understatement. I would also include a
reference with this. The ACGME report, "Advancing Primary Care" would be a good one. Revised
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Page 15, second paragraph. I would suggest revising the first sentence: "The cluster
methodology used in this study revealed unexpected interest spectrums in two specialties:
cardiology and emergency medicine." – the sentence was changed to: “The cluster method
used in this study revealed results for cardiology and emergency medicine that deviated from
the expected.”
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Page 15, second paragraph, last full sentence. You write that interventional cardiologists
have been "recruited" from internal medicine programs. I think this is an incorrect phrasing,
that has the effect of diminishing the importance of the education in human physiology and
medical management that takes place during an internal medicine residency program. IM
residents are not a recruitment pool; IM residency is the foundation for the cardiology
education that comes after. But I also see your larger point. Can you say this differently?
Revised to: “These findings are important given the increasing demand for interventional
cardiologists, who in many countries sub-specialize in cardiology after completing internal
medicine residencies [31].”
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Page 16, first full paragraph, line 371. Change "students" to "students'" – Done “
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Page 17, paragraph 1, line 392-395. Please revise this sentence into two sentences, and
remove the "i.e." because it serves no purpose here. – Revised: “These data portend future
problems for the healthcare system, especially since psychiatry and anesthesiology are the
5th and 6th largest single specialties, respectively, (when the aggregate of internal medicine
subspecialists is not included) and are already suffering from insufficient workforce [33].”
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Page 17, paragraph 2, lines 401-404. Please rewrite this sentence without the "i.e." and
consider simplifying it or changing it to two sentences. – Rewritten – “Among the strengths
of this study is its trans-disciplinary approach. It melds the vocational career concept that
career selection involves choosing from a cluster of related vocational interests with methods
traditionally used to examine the medical specialty selection process.”
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Page 18, paragraph 1. Remove "such as can occur during the internship year" (redundant) removed
Conclusions
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Page 18. "world-over" is not a word. Please revise. – changed to “worldwide”
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Page 18, line 424. Remove the comma after "trends" - removed
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Last sentence. I would indicate that this study adds to previous literature that students are
looking for a cluster or "package" of characteristics. This study certainly contributes to that
hypothesis, but it is not a new idea or finding. Revised to “Moreover, this study adds to
previous studies by showing that students are not looking only for individual aspects of a
specialty, but for a package (or “solution”) that includes a cluster of socio-environmental,
economic and occupational features [38].”
Figure 2. As requested previously, please fix this figure so that words do not overlap with lines
in the figure (specifically, "Subspecialties"). You may need to abbreviate or break this word
across lines of text in order to accomplish this. You might also be able to adjust the shapes and
sizes of the ellipses. – Fixed the Figure so that “subspecialties” is better seen.
Appendix, section 2 (page 36). I believe there is a typo in this table - "beside" should be
"bedside"- done